The role of expanded coverage of the national vitamin A program in preventing morbidity and mortality among preschool children in India

Richard David Semba, Saskia De Pee, Kai Sun, Martin Bloem, V. K. Raju

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Higher food prices increase the risk of vitamin A deficiency among preschool children in poor families, because a larger part of the household food budget is spent on grain foods and less on vitamin A-rich foods. Vitamin A supplementation is an important source of vitamin A for children. Our objective was to characterize coverage of the India national vitamin A program for preschool children and identify risk factors for not receiving vitamin A. Anthropometric and demographic data were examined in 23,008 children aged 12-59 mo in the India National Family Health Survey, 2005-2006. Within the last 6 mo, 20.2% of children received vitamin A supplementation. The prevalence of stunting, severe stunting, underweight, and severe underweight was higher among children who did not receive vitamin A compared with those who received vitamin A (P <0.0001). In families with a child who did and did not receive vitamin A, respectively, the proportion with a history of under-5 child mortality was 8.4 vs. 11.4% (P <0.0001). By state, vitamin A program coverage was inversely proportional to the under-5 child mortality rate (r = 20.51; P = 0.004). Maternal education of ≥10 y [odds ratio (OR) 2.22; 95% CI 1.69-2.91], 7-9 y (OR 1.99; 95% CI 1.57-2.53), or 1-6 y (OR 1.65; 95% CI 1.28-2.13) compared with no education was an important factor related to receipt of vitamin A. Poor coverage of the vitamin A supplementation program in India has serious implications in the face of rising food prices. Expanded coverage of the vitamin A program in India will help protect children from morbidity, mortality, and blindness.

Original languageEnglish (US)
JournalJournal of Nutrition
Issue number1
Publication statusPublished - Jan 2010


ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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